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KMID : 1009020150130020218
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Clinical Psychopharmacology and Neuroscience
2015 Volume.13 No. 2 p.218 ~ p.221
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Recurrent Idiopathic Catatonia: Implications beyond the Diagnostic and Statistical Manual of Mental Disorders 5th Edition
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Stanley N. Caroff
Irene Hurford
Henry R. Bleier
Gregg E. Gorton
E. Cabrina Campbell
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Abstract
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We describe a case of recurrent, life-threatening, catatonic stupor, without evidence of any associated medical, toxic or mental disorder. This case provides support for the inclusion of a separate category of “unspecified catatonia” in the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) to be used to classify idiopathic cases, which appears to be consistent with Kahlbaum’s concept of catatonia as a distinct disease state. But beyond the limited, cross-sectional, syndromal approach adopted in DSM-5, this case more importantly illustrates the prognostic and therapeutic significance of the longitudinal course of illness in differentiating cases of catatonia, which is better defined in the Wernicke-Kleist-Leonhard classification system. The importance of differentiating cases of catatonia is further supported by the efficacy of antipsychotics in treatment of this case, contrary to conventional guidelines.
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KEYWORD
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Catatonia, Periodic catatonia, Schizophrenia, Cycloid psychosis, Antipsychotic agents, Neuroleptic malignant syndrome
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